1. Unit 34 Care of the client with Gastric Carcinoma
Fujian Health College
Surgical Nursing Department

2. What is Gastric Carcinoma?
Gastric Cancer
A malignant growth in the stomach.
Risk Factors: diet high in complex carbohydrates, grains and salt, low in in fresh, green leafy vegetables and fresh fruits, smoking, alcohol ingestion, use of nitrates and history of gastric ulcers.
Complications: hemorrhage, obstruction, metastasis and dumping syndrome
Goal of treatment: To remove the tumor and provide nutritional program.

3. Signs and Symptoms Fatigue Anorexia and weight loss
Nausea and vomiting
Indigestion and epigastric discomfort
A sensation of pressure in the stomach
Difficulty of swallowing (dysphagia)
Anemia
Ascites
Palpable mass

4. Nursing care for patient with Gastric carcinoma
Monitor vital signs.
Monitor hemoglobin and hematocrit and administer blood transfusion as prescribed.
Monitor weight.
Assess nutritional status, encourage small, bland, easy digestible meals with vitamins and mineral supplements.
Administer pain medication as prescribed.
Prepare the patient for chemotherapy or radiation therapy as prescribed.
Prepare for possible surgical removal of the tumor.

5. Post- operative Nursing care
Monitor vital signs.
Place in Fowler’s position (90 degrees) for comfort.
Monitor intake and output, administer fluids and electrolyte replacement by IV as prescribed.
Maintain NPO status as prescribed for 1 to 3 days until peristalsis returns.
Monitor nasogastric suction.
Do not irrigate or remove the nasogastric tube (NGT).

6. Post-operative Nursing care
Assess for bowel sounds.
Advance diet from NPO to sips of clear water to six small bland meals a day, as prescribed.
Monitor for monitor complications of hemorrhage, dumping syndrome, diarrhea, hypoglycemia ( low blood sugar) and vitamin B12 deficiency.